肺癌DCE-CT技术与肿瘤血管生成的相关研究

目的用动态增强CT功能成像(DCE-CT)的方法观察肺癌肿瘤血管生成。方法对28例肺癌进行DCE-CT扫描,记录强化峰值(PH)、肿块强化达到峰值时间(Tp),计算肿块与主动脉强化峰值之比(M/A)、灌注值、相对血管容积(rBV)和毛细血管通透值(Pm),将各值分别与肺癌微血管密度(MVD)做相关性分析。将28例肺癌分为血管内皮生长因子(VEGF)表达阳性组和VEGF表达阴性组,分析2组MVD、各成像参数以及淋巴结转移情况的差异。结果 PH、M/A、灌注值、rBV、Pm分别为(27.03±8.89)HU、0.13±0.07、(0.33±0.06)μL.min-1.ml-1、(27.00±10.95)%、(188.90±133.10)μL.min-1.ml-1。PH、M/A、灌注值、rBV与MVD呈正相关,其中,灌注值与MVD相关性最高(r=0.78,P<0.0001),Pm值与MVD无相关性(r=0.29,P>0.05);VEGF阳性组MVD和CT功能成像参数高于VEGF阴性组,两组淋巴结转移情况差异有统计学意义(χ2=9.389,P<0.05)。结论 DCE—CT可得到比较全面的肺癌血供情况,能为肺癌肿瘤血管生成的评估提供新方法。

Correlation Studies of Dynamic Contrast-Enhanced Computed Tomography Functional Imaging for the Observation of Tumor Angiogenesis in Patients with Lung Carcinoma

Objective To investigate the role of dynamic contrast-enhanced computed tomography （DCE-CT） in the observation of tumor angiogenesis in patients with lung carcinoma. Methods 28 patients with pathology-proved pulmonary carcinoma underwent DCE-CT scan before operation. The functional imaging parameters： peak height（PH）, the time of peak height（Tp）, the ratio of PH of the mass to aorta（M/A）, perfusion, the relative blood volume （rBV） and permeability （Pm） were calculated and correlated with the microvesset density （MVD） of the carcinoma. The functional imaging parameters MVD and the lymph node involvement between VEGF positive group and VEGF negative group were analyzed. Results The Perfusion, PH, M/A and rBV correlated positively with MVD （r=0.78, 0.66, 0.69, 0.70 respectively; P〈0.0001）, and no significant correlation was found between Pm and MVD （r=0.29, P〉0.05）. The functional imaging parameters and MVD of VEGF positive group were higher than those of VEGF negative group （P〈0.05） and the difference of lymph node involvement between two groups was significant （X 2=9.389, P〈0.05）. Conclusion DCE-CT functional imaging technique provides general information of lung carcinoma angiogenesis and alternates non-invasive option for observation of tumor angiogonesis in patients with lung carcinoma.